While suicide rates in Minnesota have steadily increased for the past 20 years, some rural counties are showing higher rates than more populated areas — and different efforts are underway to address the root causes behind that.
In a conversation earlier this month led by the Center for Rural Policy and Development, a think tank based in Mankato, mental health professionals and experts talked about mental health challenges in rural areas.
From 2018 to 2021, the state’s highest suicide rates were in the northeast and northwest parts of the state while the lowest rates were in the seven-county metro area, according to a report released by the center in February.
The data also shows that suicide rates in the most rural counties are trending up faster than in more populated counties.
What’s behind the trend?
There are various underlying reasons that rural counties have higher rates of suicide, including a lack of access to mental health care, financial barriers, more jobs that involve physical labor, privacy concerns about seeking help and access to firearms, according to the Center for Rural Policy and Development’s report.
A different report from the center, from 2023, found that the most densely populated counties averaged one licensed professional for every 197 residents, while the least populated counties averaged one licensed professional for every 741 residents.
During the webinar, mental health providers talked about privacy concerns and about a stigma that persists in rural communities.
“Many people simply don’t have conversations when they’re starting to have thoughts of suicide. They will keep that to themselves. They’re afraid of what happens,” said Tracie Rutherford Self, a professor in the Department of Counseling and Student Personnel at Minnesota State University, Mankato.
She said some professionals don’t know how to ask about suicidal thoughts, so it goes unnoticed.
Supporting data from 988 — the national suicide & crisis lifeline – shows that Northeast Minnesota has the lowest use of the line, but the highest rate of suicide, of any region in the state, demonstrating that many people don’t reach out.
“Individuals who died by suicide from rural communities almost never have a mental health diagnosis prior to their death,” Rutherford Self said. “They’re not seeing a mental health professional.”
What does the data show?
The state’s 2023-2027 suicide prevention plan identified the communities that have higher than average suicide rates: youth ages 10-24, middle-age males, Black people, veterans, people with disabilities, members of the LGBTQ+ community and Native Americans.
Farmers are also an important area of consideration as farm work makes up almost 20% of the employment in rural areas of Minnesota, according to 2022 data from the federal Bureau of Economic Analysis.
Panelists said farmers face certain challenges, like the burden of maintaining a family farm legacy, the volatility of markets and chronic pain from physical labor.
The Minnesota Department of Agriculture has recognized a need for faith leaders to be well-versed in suicide prevention and is offering prevention training for those who serve congregations of various faiths. Registration for the training is open until April 5.
Minnesota also has a Farm Stress Certification Program for Counselors for counselors to get specific training in understanding some of the challenges farmers face, though there are currently only two providers with this certification.
“Rural cultural competence is important for providers … who may be coming into rural areas,” Marnie Werner, the vice president of research at the Center for Rural Policy & Development, said during the webinar. “Understanding rural culture is important, too; there’s a high value on independence and self-reliance.”
Recommendations from the panel included more investment in preventative education around suicide and efforts to reduce the stigma through local communities.
In 2021, Minnesota received a $500,000 grant from the U.S. Department of Agriculture to help address the mental health struggles of Minnesota’s farmers. Funds were used to support initiatives by local organizations and to help farmers with some of the stressors they face, such as finding legal help.
But there’s another challenge, too. When someone does seek help, they’re met with long wait times in the emergency room before there’s an open bed in a mental health facility.
“I’ve had my own clients where they look at me and say, ‘We think the suicidal crisis has passed.’ They’ve never gone past the ER, and then they go home. If that’s happening, then they’re not getting the care they need,” Rutherford Self said. Panelists said that recruitment of mental health providers is key to supporting rural communities. One recommendation from the center is to provide more financial support for students who choose to intern in rural areas, in hopes that they come for an internship and then decide to stay and practice there.
Ava Kian
Ava Kian is MinnPost’s Greater Minnesota reporter. Follow her on Twitter @kian_ava or email her at akian@minnpost.com.
